UnLtd Blogs - resilience

'Tis the season for tension and re-hashing old scores

Sun, 10 Dec 2006 10:38:24 +0000

There are lots of kill-joy stories circulating about elderly people being upbraided for asking about the switching-on of the Christmas Lights rather than Winter Lights. And stories about singing services being cancelled for being insufficiently multi-denominational. In the US, some groups have brought successful law suits against towns whose public displays are reportedly too secular. In contrast to these stories, the Guardian has a thoughtful piece that suggests that many of these Grinch stories have little or no basis in fact: The phoney war on Christmas.

Rather than the usual, “the personal is the political”, it seems as if the personal experience is spreading to the political. If your family’s version of holiday spirit has usually been interpreted rather too literally (and liberally), leading to family tension and the annual re-hashing of old scores, then this is your kind of public holiday season. And, by and large, no alcohol has been required, just plain mean-spiritedness.

A friend works for a dictionary publishers and is the go-to person in many circles for linguistic niceties. She and her siblings now have their own families and gather together at her mother’s on set-piece days. A while ago, her mother was watching a reality programme and asked her, “What’s a dysfunctional family?”. In an admirable economy of words, my friend replied, “You know the way we all get on Boxing Day”; her mother nodded, “Well, dysfunctional families are like that the whole year round”.

Answering "How are you?": counting blessings

Wed, 06 Dec 2006 15:18:36 +0000

Apparently, in Latin, you can ask a question that anticipates the answer. So, you use some grammatical forms if you expect the answer ‘No’, and others (presumably), if you expect the answer ‘Yes’. It sounds like an ancient form of mind-games and casts a new light on the art of conversation. But so often, our conversations can be formulaic, and this is especially true when it comes to social comments.

When I worked in Loughborough I was initially taken aback when the response to my polite enquiry, “How are you?”, was met with, “Fair to middling”. I was so accustomed to, “Fine”, that I didn’t know if the correct social action was to overlook it, or to enquire further and run the risk of learning more about IBS or the agonies of an enlarged prostate than I cared to know.

Throughout the UK there are local customs that dictate the answer to the question “How are you?”. I came across an item on blessings and the tricky task of navigating the appropriate answer to this question.

When someone asks me: How are you? 99% of the time I will answer “fine”. In Hebrew, you say, beseder, literally, in order, ok. It’s, “thanks for asking but I don’t need any special consideration right now, I’m ready to proceed”.

The Biology of Emotional Healing

Thu, 12 Oct 2006 14:06:28 +0000

I've previously written that moods and emotions are contagious. There is an interesting piece on this notion in the New York Times, Friends for Life: An Emerging Biology of Emotional Healing. (If the NYT bugs you for a log in, then follow the instructions at Bug Me Not.)Research on the link between relationships and physical health has established that people with rich personal networks � who are married, have close family and friends, are active in social and religious groups � recover more quickly from disease and live longer. But now the emerging field of social neuroscience, the study of how people�s brains entrain as they interact, adds a missing piece to that data.It's a light, readable discussion that mentions mirror neurons as an explanation for emotional contagion, which expresses "the tendency of one person to catch the feelings of another, particularly if strongly expressed".

There's also a discussion of Cacioppo's work. He makes that interesting argument that the

emotional status of our main relationships has a significant impact on our overall pattern of cardiovascular and neuroendocrine activity. This radically expands the scope of biology and neuroscience from focusing on a single body or brain to looking at the interplay between two at a time. In short, my hostility bumps up your blood pressure, your nurturing love lowers mine. Potentially, we are each other�s biological enemies or allies.

This is a fascinating way of understanding all of our relationships and particularly the very strong relationship between carers and those for whom they care.

Happiness and The Moral Consequences of Economic Growth

Wed, 30 Aug 2006 08:40:54 +0000

Polly Toynbee has written a piece asking "why have we never had it so good". She argues that:

There has never been a better time to be alive in Britain than today, no generation more blessed, never such opportunity for so many. And things are getting better all the time, horizons widening, education spreading, everyone living longer, healthier, safer lives.

However, it doesn’t seem as if all of these "[u]nimaginable luxuries and choices" have increased our happiness levels: it is also not clear that the opportunities and benefits that she describes with such approbation are available to all. Many people are involuntary participants in the postcode lottery that governs whether or not you are eligible for a variety of procedures on the NHS (e.g., cardiac catheter ablations). And the increase in foreign travel and holidays is limited: the number of British people who did not take a holiday over the course of a year has remained stable at 41 per cent over the last three decades.

Brad DeLong has posted an extensive and interesting review of Ben Friedman's thought-provoking The Moral Consequences of Economic Growth.

Happy Danes and Miserable Brits?

Sat, 29 Jul 2006 10:51:31 +0000

A researcher has put together a map of happiness in the world. The map shows that Denmark is the No. 1 destination. Health levels, prosperity and education were the strongest determinants of happiness. Money might not guarantee happiness, but it does make a significant contribution when it is spend on healthcare and education. It probably comes as no surprise that Zimbabwe and Burundi come bottom: oddly enough, the USA is placed at 23 and UK at 41 out of 178 countries.

The researcher makes some interesting comments about why countries appear in the places that they do. He remarks that Asia showed up poorly despite the strong sense of family and collective identity. However, I would speculate that questions that emphasise subjective wellbeing are not culturally appropriate in several countries. Although there is some mention of lower levels of happiness in countries with large population, the examples cited seem to relate more to high population density than large populations (they may overlap but are not necessarily synonymous).

Of course, according to a recent item in The Guardian, happiness is over-rated. Happiness does seem to be a red-rag that precludes discussion of the benefits that it confers. Apart from novels and philosophical/religious speculations about the spiritual ennoblement that suffering gives us, where did we develop the idea that lessons in how to develop our mental and physical fortitude would reduce us to the blandly chipper, annoying others with our mindless cheer and groundless optimism? We can't eradicate sadness or adversity: they are a natural part of life's rhythms. But, for some people, it does seem as if we can do something about our ability to cope with such circumstances.

Happiness, Unhappiness, Depression and The Personal and National Economies

Thu, 20 Jul 2006 10:22:37 +0000

I've previously offered a bone-achingly long post that shares my confusion about the topic Is Unhappiness A Symptom Or A Passing Phase. A handwave summary would be that unhappiness is part of the rhythm of our lives: however, when it persists it can be part of the symptom spectrum of depression. There is professional conflict that suggests that depression is over-diagnosed, and under-diagnosed according to demographic groups (e.g., under-diagnosed in men) and that it is over-medicated or under-medicated. There is little conflict over the life-distorting impact of depresson and its implications both for personal quality of life and well-being (a personal economy) and the general economy (depression can impact people's ability to be economically active). I hope that is clear (yes, your suspicion that I'm at the state of ignorance where all I can say is "One the one hand this. On the other hand..." is absolutely true). I am choosing to bodyswerve any attempt to summarise whether depression statistics should be included in any discussion of happiness economics.

Anyhow. I've introduced more confusion into my thinking by reading the transcript of a thought-provoking debate between psychiatrist Raj Persaud and happiness economist, Lord Layard. As part of the background to the debate, we are told that although research indicates that money doesn't necessarily make us happier, "the greatest predictor of unhappiness...is still real poverty and hardship, with mental illness a close second". It is from this position that Layard argues:

...that public policy, and even how we spend our time, should be more devoted to trying to help people who are very unhappy. There�s another reason there actually, which is in the research and has not been pointed out very much. We know a lot more about what makes the difference, what causes the difference between the misery and average happiness. Knowing what causes the difference between average happiness and great happiness, we have it more in our power (as well as it being a duty) to do more about the least happy.
�Unfortunately this is not the way the government has been thinking up till now. Psychiatry and psychology have been Cinderella sections of the NHS. If you have blood pressure (I have) or a skin problem, or asthma, or diabetes, or whatever, you will almost automatically, at some point, see a specialist. But not if you have a crippling depression which is stopping you from working for a year; you�re extremely unlikely to see a specialist. Not more than 10% of people in that condition will see a specialist, and this reflects I think our obsession at the moment with �objective indicators� rather than the feelings of people, which are what I believe matter most of all. So it�s encouraging that by pointing out some of these facts, there is now a move going on in the government to provide more psychological therapy, which is of course what these patients want, they just don�t want to be put on a few pills by the GP and sent off home.

Unlike the usual discussion as to whether unhappiness is a prodrome for depression in the way that high blood pressure is for heart disease, Layard is proposing a call to action that discusses misery, unhappiness and depression as if they are synonyms. Persaud commends Layard's work for promoting positive psychology as a necessary part of public policy. He disputes Layard's definition of happiness and how it is measured: he argues that we need to take personal responsibility for our own happiness.

Internality and externality are two key dimensions the psychologists feel you can divide the population over. Internals are people who take responsibility for their lives, they believe that they can have an impact on the future of their life, on their destiny. And they believe their destiny is in their hands. Externals, on the other hand, believe that their life is down to external forces beyond their control and they have very limited ability to control their future.
...externals are more prone to various problems.

Persaud speculates that a blame culture is pushing more of the population in an external direction.

And the squeezing out of personal responsibility means that people are much more external in orientation. And it has dramatic implications for happiness, because externals feel happier in the short run, because when bad things happen to them, they can always blame someone else for why it happened to them. But in the long run, because they don�t take personal responsibility for their lives, they�re not going to be successful.

Persaud suggests that the pernicious effect ascribed to television and other entertainment media (similar to the earlier discussion of television) could be mitigated by

educating people as to the dangers of the entertainment industry and then leaving it to people to make decisions for themselves.

Persaud also outlines the research that shows that we are notoriously poor at predicting what will make us happy. Accepting this, he says:

I would be worried about governments saying, well, you know, you guys are really bad at this decision-making stuff; we�re going to take over and help you with your decisions. I think people should be educated about the fact that they�re error-prone when it comes to these decisions, but hopefully with that education they�ll be moved to a place where they can make better decisions over happiness.

Entertainment and public policy are both sources of mis-information and FEAR (False Experience Appearing Real). Both Layard and Persaud discuss the corrosive impact that these can have.

Now you�ve got this extraordinary view, which is obviously completely wrong, that there are many people according to the surveys, people in their late teens or early 20s, who think they�re not going to be as rich as their parents. Now this is completely fatuous. It�s inconceivable that that should come about. And yet this is the atmosphere of fear and anxiety that�s been created.

Persaud summarises the influence of politics on our sense of well-being. Both agree that it would be better if politicans and public policy:

encouraged more that we thought about positive emotions, like happiness and wellbeing. And encouraged ourselves to orientate ourselves towards positive emotions like wellbeing, and that we voted on that rather than voting on fear.

It's an intriguing discussion. I am not convinced that we can only shed unhappiness with the aid of a psychologist or psychiatrist. Intervention-based studies by positive psychologists such as Seligman and Reivich argue that we can change how we experience our lives and the quality of our lives by learning to be happy/more resilient. However, although happiness is a legitimate individual pursuit that can be self-cultivated, it seems as if there is a role for our local and national governments. Researchers like Ed Diener say that it is easier to be happy when there is a sense of trust, safety, stability and security. He says that governments can create conditions such as recreational facilities, working hours legislation, a health infrastructure and transport infrastructure that have a profound influence on people's happiness. One thing is certain, happiness can have a profound effect on our personal and national economies and deserves more attention (e.g., the cost of providing mental health treatment for the estimated 1 in 10 british children who are in need of it).

Happiness And Resilience Lessons For Children

Sun, 09 Jul 2006 08:58:09 +0000

Following the disastrous report into the state of children's and adolescents' mental health I was wondering about the only possible mechanism for delivering appropriate interventions for children who need them.

So, I'm pleased to see that the Independent on Sunday carries a story about Prof. Marty Seligman being invited over to the UK to train teachers in delivering happiness and resilience lessons to children. It's an exciting prospect. It is more than a little interesting that the reporter has made the usual mistake of referring to Seligman as the "guru of positive thinking" as if it is a synonym for positive psychology and as if Prof. Seligman has accepts the annointment as "guru".

I think that this is an excellent innovation (particularly because it seems as if parents will be allowed to participate) but it is not clear that this is meant to address the needs of children identified in the BMA report as in need of treatment. Apparently, the "anti-depression classes" have been approved by Lord Layard. Now, the classes are either happiness and resilience classes or they are anti-depression: it is hard to imagine that they are synonymous. This is very sloppy reporting.

The move comes as experts warn that record numbers of young people are on the verge of mental breakdown as a result of family break-up, exam pressures and growing inability to cope with the pressures of modern life. Figures show that at least 10 per cent - three children in every average-sized class of 30 in the country - are experiencing symptoms of severe depression, including suicidal thoughts, prolonged bouts of despair and the urge to cry on a daily basis.

Irritatingly, the IoS's third article then styles the lessons as optimism lessons. Yes, there are overlaps but be consistent. It is ludicrous that there are three articles but it is still not clear what the lessons are and whether they are offered to all pupils as a means of developing resilience (probable) or considered to be sufficient for the children identified as having severe mental health problems. If it is the latter, it would have been helpful if the articles had mentioned the involvement of family doctors or any psychologists or psychiatrists who are already involved in the family.

Stress Therapy Offer To Ill Jobless: Really?

Thu, 06 Jul 2006 07:29:17 +0000

According to The Guardian, the government is about to offer stress therapy to people who have had to quit work because of stress or depression.

So, would this be a separate plan to the Layard proposal for enhanced access to cognitive-behavioural therapy? Or is this a separate proposal? If so, is this a well-researched and validated programme? Or is it a nice, worthy sounding initiative that is not expected to go anywhere?

Why focus on stress therapy? Has anyone looked at the possibility of focusing on people's character strengths and virtues and using those to help someone to help themselves? Has there been any investigation of resilience work that would not only relieve stress in the short-term but sustain it? Is accepting the health benefits of positive emotion still too much of a leap of faith?

Loneliness: Damages Your Health And Well-being

Mon, 03 Jul 2006 07:49:47 +0000

If you are over 50, loneliness can add up to 30 points to your blood pressure. The relationship holds even after allowing for other negative emotive states, like sadness, stress or hostility. A 30 point difference is enough to recategorise someone from normal blood pressure to hypertension. (The study looked at the impact on systolic blood pressure, the top number in the BP reading.)

Friendship and social connections are important parts of happiness: they contribute to our resilience. Bowling Alone by Robert Putnam and a recent study by Lynn Smith-Lovin draw attention to the sharp contraction of inner circles until it only includes close family or a spouse. It seems that we are more protected from adverse events if we have several people with whom we can discuss important issues.

Loneliness has such a significant impact on hypertension in older people that it is estimated to be of a similar order of magnitude as the well-accepted risk factors, such as obesity or sedentary lifestyles. People can be socially active but still feel lonely. It seems that feelings of loneliness are a health risk. The lonelier somebody is, then the higher the blood pressure. Hypertension is known to have negative health consequences. Loneliness is probably a significant contributor to our Hearts and Minds Age.

Big Brother Monitoring Won't Alienate Anyone, Will It?

Mon, 26 Jun 2006 11:45:15 +0000

Greetings Comrades, there are exciting proposals that will lead to a revolution in how we raise our children. The government is proposing a database that will track all children from birth in England and Wales. The database will contain a rich assortment of data about children; from "how they are doing in class to whether they are eating enough fruit and veg".

These proposals are nothing like the punitive overtones of the recent Supernanny Initiative. They will form part of a Brave New World in which we will fit children with RFID chips, in-built cameras that will let us know how they interact with their environment and authority figures, and in vivo monitoring that will let us know what they are eating. Repeated failure to achieve the 5 a day target will trigger a reminder text.

Ignoring the fact that this proposal is monumentally unworkable, as should be apparent to anyone who has followed the NHS IT fiasco, what were the proposers of this scheme thinking? Or weren't they? Read Shinga's Since When Have Bureaucracy And Databases Been Synonyms For 'Solution' on this scheme. I will add that there is a lot of evidence that alienation from the environment or social system in which one lives is frequently cited as a factor in depression and anxiety. So, having your children monitored from birth isn't going to unsettle or alienate anyone, is it? It isn't possible that this bold social policy will result in greater levels of depression or mental illness?

What Am I Bid For This Part Of My Life?

Tue, 20 Jun 2006 15:10:15 +0000

Following on from yesterday's exploration of Putting Your Life Out To Tender I'm wondering about what bids we might attract for different areas of our life. If you were auctioning off areas of your life like happiness, family relationships, career, health etc. how would you describe them, and what value of bid would they be likely to attract? Do you eat a healthy diet? If you had valuable traits like high resilience, how much would that be worth? Of course, having read Shinga's piece on genetic determinism, how much is your gene profile worth? And is your environment adding to your nett worth or causing a major economic deficit?

Putting Your Life Out For Tender

Mon, 19 Jun 2006 14:23:44 +0000

Greavsie has had the splendidly lunatic/inspired idea of putting his life out to tender. He is inviting offers:

in 6 operating areas:
Family greavsie

Work greavsie
Social greavsie
Love-life greavsie
Spiritual greavsie and;
Intellectual greavsie

Interesting operating areas. A while back, everyone seemed to be quoting Phil McGraw's comment that if most people had a Life Manager who was responsible for the current state of their life, they would sack that manager.

If you had managers responsible for life operating areas that were important to you - like health, resilience, happiness, career etc. would you be sacking them after their latest disappointing performance reviews, or giving them a bonus?

When Will The Vacant Lot Be Developed?

Wed, 14 Jun 2006 14:04:51 +0000

When I saw the rubble with the provocative question, "What happens when edifices of network TV are rubble and the vacant lot has yet to be developed?" I wondered if the same is true of lots of social conventions, like consumerism and hedonism. Both of them are valuable and have their strengths - but they do seem to be crumbling in their anecdotal strength with reports of a decline in shopping and doubts about the health impacts of binge drinking.

A number of social commentators lament the impact of marriage or relationship breakdown, particularly where children are involved. It seems as if we have crumbling edifices but lots of vacant lots waiting to be developed because we don't know what should take their place. What do we want? What do people need? Are these the same question?

I've been thinking about this because it's Carers' Week and although I've had a good response to the workshops that I've run, I've met a lot of carers who are angry about what has happened to their lives and the lack of support they receive. Some of the carers I met say that they feel like anachronisms. They are abiding by their understanding of family responsibility and loyalty and almost literally being beggared for it while being treated with what feels like contempt by many of the statutory agencies. SOme of them feel that they have traded in their desire for security and a fulfilling career for present discomfort, financial insecurity and worry about their own futures. Yet, what would happen to our social and healthcare systems if carers disowned their sense of obligation and responsibility (a question that I've asked before when wondering what is the cost of doing nothing?)?

Rely On The Kindness Of Strangers

Fri, 09 Jun 2006 17:52:05 +0000

According to Wired, researcher David Baker is relying on the kindness of strangers to generate the key to an AIDS vaccine or a cure for cancer by creating a virtual super-computer. Sometimes, in addition to techno-stars, we need basic services and kindnesses. An individual contribution to Baker's search for scientific solutions might be

that old PC sitting under a layer of dust in your closet or the one on your desk doing little else but running a screen saver.

Baker's Rosetta@home project is putting together the spare computing power of tens of thousands of PCs throughout the world to work away at scientific problems over the internet. Owners install free software on the PCs and

when the machine is idle, it figures out how an individual protein � a building block of life � might fold or contort, displaying the possibilities in a screen saver. When the PC is done crunching, it sends the results back to Baker's team and grabs more work.

More than 60,000 people currently donate computer time and Baker is looking to increase that number ten-fold.

Rosetta@home is a tremendously exciting project and is creating virtual communities of people who feel actively involved in the research effort and the potential medical impact of the work. What would happen if we could harness people's goodwill to produce a virtual community of people willing to improve their own well-being and that of others? In The Tipping Point, Malcolm Gladwell promotes the idea that small actions can spark “social epidemics”, that are good for our well-being. What small actions could we do and what would we be willing to do? Is the greatest apprehension the fear of the open-ended commitment and of exploitation? Does the Rosetta@home project work because there is a clearly defined limit to the contributions (e.g., spare computing power, when the computer is turned on?).

Happiness-Adjusted Age Relative To Chronological Age?

Fri, 02 Jun 2006 13:48:56 +0000

There are several age-adjusted health scales used to horrify or shame us about our lifestyle choices and health. Real Age claims to calculate the biological age of your body, based on how well you maintain it. HeartAge can be used to tell a 42-year-old man that after a cardiovascular risk-adjustment, he has the heart of a 70-year-old man. There are anxiety and depression scores and quality of life scores. I'd like to propose an risk-adjusted happiness and resilience score for age. Imagine hearing, "You have the body of a 23-year-old but your lifestyle choices and general grumpiness gives you the Mind-Body score of 58-year old".

HeartAge is a novel use of the Framingham Heart Score: it has been reported in Patients' Perceptions of Cholesterol, Cardiovascular Disease Risk, and Risk Communication Strategies. A series of focus groups compared three strategies for communicating cardiovascular disease (CVD) risk. Participants saw three visual displays that represented the CVD risk for a 42-year-old man with a Framingham Heart Score that predicted a 25% probability for a CVD event within the next 10 years. A crowd chart showed 100 stick figures with 25 of them shaded to indicate the proportion predicted to have a CVD event over the next 10- years: this was contrasted with a similar chart for a same-aged man with no risk factors (1 figure shaded). Similarly, this same information was compared and contrasted in a simple bar graph. The HeartAge was also presented as a chart. But this time, a horizontal bar chart represented age. The first bar depicted the chronological age (42 years);

the second bar showed how this individual compared with the average age of a same-sex person in the Framingham Heart Study having the same 10-year probability of experiencing a CHD event. For the demonstration case, the 42-year-old had the same risk as a 70-year-old.

Analysis of the participants' reactions and responses revealed that the standard visual representations that show statistical probabilities of risk are confusing and uninspiring. However, a strategy that provides a cardiovascular risk-adjusted age calculation was

evaluated as clear, memorable, relevant, and potentially capable of motivating people to make healthful changes.

The BODE index is gaining in popularity for assessing people with chronic obstructive pulmonary disease (COPD). BODE is a combination of physical and physiological indices and measurements: it can be used in conjunction with quality of life questionnaires to present a full picture of a patient's health and well-being.